From the NHS or an acupuncture organization? To my knowledge, the two considerations you mentioned are most important- the babies are in separate sacks and presenting twin is breech. As long as there are no other complications with this pregnancy I am unaware of any research or evidence showing moxa would be a problem. Please let me know if you find any further information. Click here to cancel reply.
How Might It Help? The use of acupuncture and moxibustion for non-cephalic head down presentation is ideal for: Women between weeks pregnant. In the review, quoting from the plain language summary they found: Previous Article Next Article. Reply Hi Natasha, Thanks for your question. Subjects with persistent breech presentation after 2 weeks' treatment intervention group or observation control group could undergo ECV. Moxibustion in the early third trimester and ECV in late pregnancy are the standard care for breech presentation in both the centers involved in the trial.
Thus and also for ethical reasons , the availability of ECV was maintained for all subjects recruited. Subjects refusing to undergo treatment were also excluded. The subjects were recruited during the routine management of normal pregnancies in the outpatient department. All procedures were executed by midwives with the supervision of physicians except ultrasound examinations and ECVs. The protocol followed the ethical standards of the Declaration of Helsinki. Pregnant women fulfilling all criteria of the study were asked to participate.
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Interested subjects gave oral informed consent. Subjects had an ultrasound scan at the 33rd week. On the day of the ultrasound scan by which breech presentation was confirmed, the selected subject was randomly assigned to 1 of the 2 groups. The sample was randomly allocated by numbered envelopes randomized in groups of 10 by the computer program PACT, Version 2.
Cephalic version by moxibustion for breech presentation.
Once randomized, subjects and investigators were aware of group assignment. All subjects recruited were advised to avoid or, at least, to ask the investigators about other interventions or therapies that could contaminate the results of the trial. All subjects were asked to return after 2 weeks for an ultrasound check on presentation. If breech presentation persisted at this time, the subject after giving informed consent could undergo ECV in the following weeks.
All subjects were also asked to complete 2 record forms for AFMs, 1 for each of the 2 weeks subsequent to recruitment. These 2 forms were returned at the time of the ultrasound examination. Each record form had to be completed once daily for 7 days, reporting the number of AFMs counted in 1 hour if possible, between 5 and 8 PM and times of starting and finishing the count.
Finally, each subject was asked to report all significant details of her pregnancy and delivery during a personal or telephone appointment after she had given birth. The following specific information was collected: In this way, it was possible to consult other sources of information obstetrician normally consulted, obstetrician present at birth, patient record forms if the subject provided incomplete or unreliable information.
Because almost all the enrolled subjects gave birth in the same hospital where they had been studied, information about delivery was reliable and easy to check. If the subject belonged to the intervention group, she was admitted to the hospital to attend an instruction session within 24 hours of randomization, alone or with her partner or the person who was actually going to help administer the treatment.
Cephalic version by moxibustion for breech presentation | Cochrane
Teaching the technique for applying moxibustion at home included presenting the moxibustion material cigar-shaped rolls containing Artemisia , locating of acupoint BL 67, and explaining the technique for stimulation of acupoint BL During the therapy the subject relaxed in the sitting or semisupine position, with the partner sitting comfortably. The therapy was executed for 30 minutes 15 minutes per side daily for 7 days in the first 87 subjects, and twice daily in the last 43 subjects.
The subjects were allowed to choose the time, ensuring no interruptions in the therapy if possible, between 5 and 8 PM. The intensity of moxibustion was just below the individual tolerability threshold, causing hyperemia from local vasodilatation but not burn blisters. Reasons for discontinuing stimulation and consulting the investigator abdominal pain, other suspected adverse effects, sensation that version had occurred before completion of 7 days' treatment were explained to the subject, together with symptoms suggesting that version had occurred decreased pressure in the epigastrium or hypochondrium, increased pressure in the hypogastrium, pollakiuria, a "different feeling" in the abdomen.
The first stimulation session was executed in the hospital and the necessary materials for the following 6 days' stimulation were dispensed, together with the AFM record forms. Last, an examination after 1 week's treatment visit 2 was scheduled. Visit 2 included a check on presentation and collection of the AFM record form. The presentation check was by localization of fetal heartbeats and abdominal palpation Leopold maneuvers. Ultrasound examination was performed only in the event that the techniques described herein failed or yielded uncertain findings.
If cephalic version had not occurred, another week's treatment was advised if there were no adverse effects and the subject agreed to continue. Further moxa rolls were therefore dispensed to the subject with a second AFM record form. The frequency of the treatment was the same as in the first week.
Visit 3 was scheduled and executed after a further week; the procedure was the same for all treated and untreated subjects as described herein Figure 1. The primary outcomes were number of cephalic presentations at the 35th week and at birth and fetal motor activity. Secondary outcomes were compliance with treatment, observation of possible adverse effects in the intervention group and adverse events in both groups, number of cephalic versions after 1 and 2 weeks of treatment ie, 34th and 35th weeks' gestation , number of cephalic versions with 2 different dosages of moxibustion once or twice daily , number and causes of cesarean deliveries, spontaneous and induced vaginal deliveries, and Apgar score at 5 minutes.
Given that the reliability of the preliminary study was limited because it was based on retrospective data and that we decided to assess the efficacy of 2 different dosages of moxibustion, the number of enrolled subjects was increased to per group. Even if not attributable to 1 of the causes specified in the research protocol, discontinuation of treatment did not entail the subject's exclusion from the study. Outcomes of all subjects recruited were analyzed on the basis of intention to treat.
Acupuncture plus moxibustion to resolve breech presentation: a randomized controlled study.
Every possible effort was made to ascertain the reason for withdrawal. The statistical processing was performed using Epi Info, Version 6. The total number of subjects was subjects per group , recruited, randomized, observed, or treated and followed up to delivery. No significant differences emerged between the intervention group and the control group Table 1.
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Neither the placental localization and grading nor the amount of amniotic fluid at the 33rd week showed significant differences between the 2 groups. The main results of the trial are summarized in Table 2. At the ultrasound check at the 35th week of gestation 2 weeks after the first visit , 98 After 35 weeks of pregnancy, only 1 subject in the intervention group agreed to undergo ECV, but version was not obtained. Twenty-four subjects in the control group agreed to undergo ECV and in 19 subjects cephalic version was obtained. Despite this, the number of cephalic presentations at birth was still significantly different in the 2 groups: The results obtained excluding subjects treated with ECV are shown in Table 2.
Of the 98 cephalic versions obtained in the intervention group, 82 occurred during the first week and 16 during the second week of treatment. The cephalic or breech presentations observed at the second visit 35th week of pregnancy remained unchanged up to term in all subjects treated and observed, except for those successfully treated with ECV.
The only intervention allowed for the subjects in the control group was ECV during the last 5 weeks of pregnancy. They were specifically questioned at the 35th week and after delivery and none reported having been treated with moxibustion or other therapies. Among the intervention group only 1 subject failed to comply with the treatment schedule prescribed and discontinued the therapy.
At the end of the first week of treatment 8 subjects withdrew from therapy, 3 on the advice of the obstetrician for Braxton Hicks contractions, breech engagement, and maternal tachycardia and atrial sinus arrhythmia, respectively and 5 subjects for unspecified reasons.
All 9 subjects maintained the breech presentations of their fetuses to term and none of them were excluded from the statistical analysis. The form of discomfort most frequently reported by both groups was a sense of tenderness and pressure in the epigastric region or in one of the hypochondria epigastric crushing attributable to the head of the breech fetus pressing against the maternal organs.
Moxibustion a type of Chinese medicine which involves burning a herb close to the skin to the acupuncture point Bladder 67 BL67 Chinese name Zhiyin , located at the tip of the fifth toe, has been proposed as a way of correcting breech presentation. To examine the effectiveness and safety of moxibustion on changing the presentation of an unborn baby in the breech position, the need for external cephalic version ECV , mode of birth, and perinatal morbidity and mortality for breech presentation.
Acupuncture and Moxibustion for Turning Breech Babies: An Update
The inclusion criteria were published and unpublished randomised controlled trials comparing moxibustion either alone or in combination with acupuncture or postural techniques with a control group no moxibustion , or other methods e. Two review authors independently assessed eligibility and trial quality and extracted data.
The outcome measures were baby's presentation at birth, need for external cephalic version, mode of birth, perinatal morbidity and mortality , maternal complications and maternal satisfaction, and adverse events. Six new trials have been added to this updated review. One trial has been moved to studies awaiting classification while further data are being requested. This updated review now includes a total of eight trials involving women. Meta-analyses were undertaken where possible for the main and secondary outcomes.
Moxibustion resulted in decreased use of oxytocin before or during labour for women who had vaginal deliveries compared with no treatment risk ratio RR 0.